J Med Assoc Thai 2009; 92 (12):1591

Views: 1,421 | Downloads: 132 | Responses: 0

PDF XML Respond to this article Print Alert & updates Request permissions Email to a friend


Feasibility and Safety of Intra-Coronary Bone Marrow Mononuclear Cell Transplantation in ST Elevation Myocardial Infarction Patients
Srimahachota S Mail, Boonyaratavej S , Rerkpattanapipat P , Wangsupachart S , Tumkosit M , Bunworasate U , Na Nakorn T , Intragumtornchai T , Kupatawintu P , Pongam S , Saengsiri A , Pothisri M , Sukseri Y , Bunprasert T , Suithichaiyakul T

Background: Stem cell transplantation is a potential treatment to improve left ventricular ejection fraction
(LVEF) after ST elevation myocardial infarction (STEMI). However, technique and mode of transplantation,
type of cells, number of cells, and when to transplant are still unknown.

Objective: To determine the feasibility and safety of bone marrow mononuclear cell (BMC) intra-coronary
transplantation and 6-months results in patients with STEMI.

Material and Method:
After successful percutaneous coronary intervention (PCI) in STEMI patients who did
not have flow re-established within 12 hours and poor LVEF (less than 50%) by echocardiography were
enrolled. Bone marrow aspiration of 100 cc was performed in the morning. After cell processing for 3 hours,
the suspension of BMC about 10 cc were infused to infarcted area using standard PCI technique. Balloon
occlusion for 3 minutes was performed during cell infusion. Cardiac magnetic resonance imaging was used to
determine LVEF, scar volume and LV volume before and 6 months after transplantation.

Results: Five patients were enrolled between May and August 2006. Duration of STEMI before transplantation
ranged from 18 days to 14 years. Total amount of BMC ranged from 67 x 106 to 335 x 106. Number of CD 34+
and CD 133+ cells were approximation to be 0.7 x 106 to 7.7 x 106 and 0.01 x 106 to 3.04 x 106. LVEF was
increased from 36.4 at baseline to 43.3 at 6-month. NT pro-BNP level was decreased from 1105 ng/ml at
baseline to 288 pg/ml at 6-month. No complications such as chest pain, no re-flow phenomenon, ventricular
arrhythmia, or hypotension was detected during the procedure.

Conclusion:
Intra-coronary BMC transplantation in patients with STEMI in our center is feasible and safe.
LVEF was slightly improved; however, a randomized controlled study is needed.

Keywords: Intracoronary, Bone marrow mononuclear cell transplantation, ST elevation myocardial
infarction

Download: PDF